DPG11 Healthy Aging (HA)

Hello Everyone,

Wondering if anyone would be able to share their LTC facility's procedure for resident refusal of mechanically altered diets/thickened liquids, especially when MBS results indicate likely aspiration? There is some disagreement at my facility on whether or not a waiver is sufficient, if residents have to be on hospice in order to refuse, or if this simply falls in the category of resident choice/preference/autonomy?

Thanks so much!

Hello,

Thanks for your reply - it stands for Modifed Barium Swallow.

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Hello!

From what I've learned, the term waiver typically isn't used because it doesn't hold up in court. However, a resident may decline to follow recommendations under resident rights. We have them, a witness and the provider sign an Informed Choice consent stating they understand the risks associated with not following the recommendation up to and including death. The provider then charts on the education and resident's choice in their note. I care plan it and we change the diet order.

Thank you Jessica!

At our facility we do not use waivers for food or fluid textures, only for therapeutic diets (CCHO, Low Sodium). 

We provide the texture that is recommended based on an SLP or MBS exam. If a resident  consumes food outside of recommended texture, they would do it on their own and we would continue to provide ongoing education identifying risks.   We of course would always try and obtain food preferences and implement foods that naturally fall into the recommended food or fluid consistency that is recommended.  I hope this helps!